Opening the Conversation: Temporization – What is the best material for veneer temps and what are the best techniques?
This question was submitted by a general dentist: Temporization – What is the best material for veneer temps and what are the best techniques?
The following is a “discussion-opener” response by Dr. Dorothy Marko:
After 33 years, you would have tried a lot of different things. A best practice starts with an excellent wax-up of what you want your case to look like.
The lab fabricates a clear silicone template that is well adapted to the margins and gingiva. Any self or light cure temp material will work well, if the silicone matrix is well adapted and vented. There is very little trimming that needs to be done. The temps are all one piece which adds to the retention. If there is minimal reduction and the temps are loose when you remove the silicone template, I would spot etch two or more of the preps and add a dimple of flowable. After I have trimmed and polished the temps in the mouth, I would glaze the emanel bonding agent (Scotch bond-emanel bond not One Step). Of course, all occlussal adjustments have to be made. Specific post-op instructions always help too.
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I did many trials to reciment a temporary veneer: temposeal, no eugenol temporary cements and many more.
The best way to keep in place a small temporary acrylic veneer is the one you just wrote.
I do not spend or loose time with other products anymore.
The above response works very well, but presents a problem if the newer concepts of IDS (or Immediate Dentin Sealing) are followed – in this case, the temporary material will bond permanently to the preps!
Two alternative approaches are possible in this case, and have worked well for me. I usually place copious amounts of glycerin on the preps before seating the template on the preps, and ‘tease’ off the template while the material is not quite set – followed by teasing off the temporaries. After trimming and polishing, the temporaries are cemented with TempBond Clear.
The other option is to do as the post above, but first placing a thin layer of Vaseline on the preps to prevent bonding. This will allow the temporaries to be removed fairly easily at the next appointment. Of course, care will be needed to remove all of the vaseline prior to permanent cementation.
The above post, with the advice about the excellent diagnostic wax-up, is of course absolutely correct. This also allows the patient to see what the finished result will look like prior to final cementation, and is an excellent communication tool to ensure the outcome will be satisfactory.